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Seniors’ Health: Drug cuts death risk after hip fracture

Once-yearly intravenous infusion also protects against further broken bones

Researchers believe they have found a drug that can reduce the risk a person with osteoporosis will die within several years of breaking a hip.

“This is the first study that’s shown some reduction in overall mortality” after a hip fracture, says Dr. Rick Adachi, a study co-author and head of rheumatology at St. Joseph’s Healthcare in Hamilton.

The drug, zoledronic acid, is given in a once-yearly 15-minute intravenous infusion. It is already available in Canada under the brand name Aclasta for treatment of Paget’s disease, another bone condition. It is also sold at higher doses under the brand name Zometa for treatment of bone tumours.

Zoledronic acid is a bone-strengthening drug known as a bisphosphonate. Pill versions of bisphosphonates are commonly prescribed for osteoporosis, the weakening of bones that occurs with aging or the use of certain medications.

Adachi and his colleagues randomly assigned more than 2,000 people, average age 74, to receive annual infusions of zoledronic acid or an inactive placebo fluid within 90 days of surgery for a hip fracture. The participants also received calcium and vitamin D supplements, and their doctors were allowed to prescribe non-bisphosphonate osteoporosis treatments.

Over the next two years, nearly 14 per cent of participants in the placebo group suffered another fracture, compared with just under nine per cent in the zoledronic acid group — a 35 per cent risk reduction with zoledronic acid. In addition, 13 per cent of placebo patients died, compared with 10 per cent of zoledronic acid patients — a 28 per cent reduction in deaths in the zoledronic acid group.

Adachi says he doesn’t think the reduced death rate was due solely to the prevention of new fractures, and further work will be directed at finding an explanation.

He adds the most common side-effect with zoledronic acid is a flu-like illness that occurs in about one in five people after the first infusion, but clears up in about three days.

Another recent study showed the drug also reduced the risk of new fractures in postmenopausal women with osteoporosis. While coming into a clinic for an intravenous infusion might not appeal to some people, Adachi says the gastrointestinal side-effects of oral bisphosphonates are a problem for others. “I think it’ll be good for patients to have this as another treatment option.”

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